Term
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Definition
| It is a maligant tumor arising from sympatheic ganglion cells or the adrenal medulla. It is the second most common solid turmor of childhood |
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Term
| What are the common sites for Neuroblastoma? |
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Definition
| Abdomen, adrenal glands and postior mediastinum. |
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Term
| What are the clinical manifestations of Neuroblastoma? |
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Definition
| This varies according to the site of the primary tumor. For an abd mass, fever,irritablility, pain from bone metastases and orbital ecchymoses proptosis from skull metastases may be present. A hx of altered bowel and bladder patterns, anorexia, weight loss, difficulty sleeping, neurological changes and pain. |
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Term
| What is the txs of Neuroblastoma? |
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Definition
| Tx involves a combo of surgery, chemo and radiation, depending on the stage of ds and the age of the child. |
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Term
| Why is Neuroblastoma often called a "silent" killer? |
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Definition
| This is because the initial dx occurs with the turmor is in Stage III or Stage IV and 70% of the time the dx is made after metastasis has occured. |
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Term
| How old is the child usually when the dx is made? |
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Definition
| The child is usually between 2 to 4 years. |
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Term
Which of the following is the most critical physiological change required of the newborn at birth?
A)Onset of breathing
B)Body temperature maintence
C)Stablization of fluid and electrolytes
D)Closure of fetal shunts in the heart |
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Definition
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Term
Neonates are predisposed to problems with thermoregulation because of which of the following factors?
A)Renal fuction is not fully developed
B) Flexed posture favors heat loss
C) A large body surface area favors heat loss to the environment
D) A thich layer of subcutanous fat provides excellent insulation. |
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Definition
| C) A large body surface area favors heat loss to the environment |
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Term
Which of following is characteristic of a neonate's vision?
A) Pupils react to light
B) Tear glands function
C) Blink reflex is absent
D) Ciliary muscles are mature |
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Definition
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Term
Which of the following tools would be most useful to assess maternal and infant attachment behaviors?
A)Apgar
B) Ballard scale
C) NCAST Feeding scale
D) Brazelton Neonatal Behavioral Assessment Scale |
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Definition
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Term
The nurse is assessing a 3-day-old, breast=fed newborn who weighed 3400g (7lbs 8oz) at birth, The infants mother is now concerned because the newborn weighs 3147g (6lbs 15oz). The most appropriate nursing intervention is which of the following?
A) Recommend suppelment feedings of formula
B)Explain that this weight loss is within normal limits
C) Assess newborn further to determine cause of excessive weight loss
D) Encourage mother to express breat milk for bottle-feeding newborn. |
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Definition
| B) Explain that this weight loss is within normal limits |
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Term
Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?
A) Feet and hands
B) Bridge of nose
C) Circumoral area
D) Mucous membranes |
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Definition
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Term
Which of the following findings on phyical assessment of a neonate would indicate the need for further evaluation?
A)Nystagmus
B)Epstein Pearls
C)Low set ears
D)Positive Babibski reflex |
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Definition
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Term
Which of the following findings would the nurse consider normal in assessing the anterior fontanel of a neonate?
A) Closed
B) Sunken
C) Bulges when newborn is asleep
D) Pulsates when newborn is resting |
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Definition
| D) Pulsates when newborn is resting |
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Term
The nurse is using a bulb syringe to suction a neonate after delivery. Which of the following is an important consideration?
A)Compress bulb after insertion
B) Clear pharynx before nasal passages
C) Use teo bulbs syringes, one for pharynx and one for nares
D) Use bulb syringe until secretions are removed, since mechanical suction is contraindicated. |
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Definition
| B) Clear pharynx before nasal nares |
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Term
In a newborn, intramuscular vit K is administered into what muscle?
A) Deltoid
B) Dorsogluteal
C) Rectus femoris
D) Vastus Lateralis |
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Definition
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Term
The American Academy of Pediatrics recommends that the best form of infant nutrition is:
A) Exculsive breast-feeding until 1 year of age.
B) Exculsive breast-feeding until 6 months of age
C)Commerically prepared infant formula until age 1 year
D) Commerically perpared infant formula until 4 to 6 months of age |
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Definition
| A) Exculsive breast-feeding until 1 year of age. |
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Term
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Definition
| It is an embryonal tumor of the kidney that originates for immature renoblast cells. The tumor often extends from the kidneys parenchyma into the renal cavity. |
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Term
| Once a client is diagnosed with Wilms tumors, what shouldn't the nurse or provider during examination? |
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Definition
| The abd should not be palpated on Wilms tumor has been diagnosed as the tumor may rupture if manipulated, causing its cells to spread throughout the peritoneal cavity. |
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Term
| What are the treatment protocols based on for a client with Wilms tumor? |
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Definition
| Tx protocols are based on the clinical stage and histologic pattern and can include various combonations of surgery, chemo and radiation. Staging of the tumor is done during sugery. |
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Term
| What is the typical age of a child when diagnosed with Wilms Tumor? |
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Definition
| Most children are between 1 and 5 years of age when diagnosed. |
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Term
| What are the clinical manifestions of Wilms Tumor? |
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Definition
| Common sign is an abdominal mass, which is characteristically firm and smooth and usually asypmtomatic. Some childern present with abd pain, vomiting, hematuria, dysuria, frequency, anorexia, weight loss and malaise. Hypertension may also occurr |
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Term
| What congenital abnormalities are associated with Wilms tumor? |
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Definition
| Hemihypertrophy,aniridia and other genitourinary anomalies. |
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Term
| What is the most common cause of severe injury and death in the school-aged child? |
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Definition
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Term
| What is the most effective means to prevent accidents in school-aged children? |
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Definition
| Educate the child and family |
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Term
| Patrick always asks his mother why he cannot ride in the front seat of the car beside her. At what age can a child be allowed to ride in the front passenger seat of cars with air bags? |
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Definition
| It is based on height and weight , not age alone. |
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Term
Which of the following statements accurately describes physical development during the school-age years?
A) Child's weight almost triples
B) Child grows s average of 5cm(2 inches) per year
C) Few physical difference are apparent among children of different genders at the end of middle childhood
D) Fat gradually increases, which contributes to child's heavier appearence. |
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Definition
| B) Child grows s average of 5cm(2 inches) per year |
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Term
Which of the following characteristic of psychosocial development of school-age children?
A)Peer approval is not yet a motivating power
B)A developing sense of initiative is very important
C) Motivation comes from extrinsic rather than intrinsic sources
D) Feelings of inferiority or lack of worth can be derived from children themselves or from the environment |
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Definition
| D) Feelings of inferiority or lack of worth can be derived from children themselves or from the environment |
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Term
Which of the following describes the cognitive abilities of school-aged children?
A) Have the ability to reason abstractly
B) Become capable of scientific reasoning and formal logic
C) Progess form making jugdments based on what they reason to making judgements based on what they see
D) Have the ability to place things in a logical order, to group and sort, and to hold a concept in their minds while making decisions based on that concept |
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Definition
| D) Have the ability to place things in a logical order, to group and sort, and to hold a concept in their minds while making decisions based on that concept |
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Term
Which of the following describes moral behavior in the younger school-aged child?
A)The standards of behavior now come from within themselves
B) They do not yet experience a sense of guilt when they misbehave
C) They know the rules and behaviors expected of them but do not understand the reasons behind them
D) They no longer interpret accidents and misfortunes as punishment for misdeeds. |
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Definition
| C) They know the rules and behaviors expected of them but do not understand the reasons behind them |
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Term
A group of boys ages 9 and 10 have formed a "boys only" club that is open to neighborhood and school friends who have skateboards.This should be interpreted as which of the following?
A) Behavior that encourages bulling and sexism
B) Behavior that reinforces poor peer relations
C) Characteristic of social development of this age
D) Characteristic of children who are later at risk for membership in gangs |
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Definition
| C) Characteristic of social development of this age |
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Term
Bulling can be common during the school-age years, The nurse should recognize that bullying:
A) Can have a lasting effect on children
B) is not a significant threat to self-concept
C) is rarely based on anything that is concrete
D) is usually ignored by the child who is being teased. |
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Definition
| A) Can have a lasting effect on children |
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Term
Which of the following should the nurse include when giving parents guidelines about helping their children in school?
A) Punish children who fail to perform adequately
B) Help children as much as possible with their homework
C) Communicate with teachers if there appears to be a problem
D) Accept responsibility for children's successes and failures |
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Definition
| C) Communicate with teachers if there appears to be a problem |
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Term
Sleep problems in the school-age child are often demonstrated by:
A) night terrors that awaken the child
B) Delaying tactics because they do not wish to go to bed
C) Somatic illness that awakens the child
D) Increasing need for sleep time compared with adolescents |
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Definition
| B) Delaying tactics because they do not wish to go to bed |
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Term
The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. The nurse's suggestions regarding participation in sports ar this age should include which of the following?
A) Organized sports such as soccer are not appropriate at this age
B) competition is detrimental to the establishment of a positive self-image
C) Sports participation is encouraged if the type of sport is appropriate to the child's ability
D)Girls should compete only against girls because at this age boys are larger and have more muscle mass |
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Definition
| C) Sports participation is encouraged if the type of sport is appropriate to the child's ability |
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Term
The school nurse is discussing dental health with some children in first grade. Which of the following should be included?
A) Teach how to floss teeth properly
B) Recommended toothbrush with hard nylon bristles
C) Emphasize important of brushing before bedtime
D) Recommend nonfluoride toothpaste approved by the American Dental Association. |
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Definition
| C) Emphasize important of brushing before bedtime |
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Term
| What are the three characteristics of labor? |
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Definition
| Coordinated, Involuntary and Intermittent |
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Term
| What is Duchenne Muscular Dystrophy (DMD) (also known as pseudohypertrophic muscular dystrophy)? |
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Definition
| It is the most common and most severe form of muscular dystrophy in children. It is a x-linked recessive disorder primarily affecting boys. It results from mutations of the gene that encodes dystrophin. Dystrophin is a protein in the skeletal muscle, is absent in children with DMD. |
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Term
| What is the clincal manifestation of Duchenne Muscular Dystrophy? |
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Definition
| Initial muscle weakness and atrophy begin in the proximal muscles, especially of the hips, shoulders and spine. Ususally inability to get up from a supine position, difficulty running and jumping, waddling gait, difficulty climbing stairs and frequent falls. |
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Term
| At what age does Duchenne Muscular Dystrophy (DMD) develope? |
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Definition
| Between the ages of 2 to 5 years |
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Term
| How is Duchenne Muscular Dystrophy diagnosed? |
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Definition
| Primarly on clincal sypmtoms and confirmed by muscle biopsy, electromyography (EMG), and serum enzyme measurements. |
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Term
| As DMD progresses how is ambulation becomes impaired? |
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Definition
| Lordosis, scolosis, severe contractures and joint development may occur. |
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Term
| When is the Preembryonic period? |
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Definition
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Term
| Where does conception usually happen? |
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Definition
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Term
| Implantation of the zygote happens where? |
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Definition
| In the decidua(lining of the uterus that usually sloughs off during menses. |
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Term
| When is the Embryonic period? |
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Definition
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Term
| The embryo is the most sensitive to teratogens during what period of the pregnancy? |
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Definition
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Term
| When is the Fetal period of the pregnancy? |
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Definition
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Term
| When can the heart of the fetus first be heard with a doppler? |
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Definition
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Term
| When does quickening usually happen? |
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Definition
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Term
| What develops on the fetus at weeks 17-20? |
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Definition
| Vernix caseosa,lanugo and brown fat. |
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Term
| Why is surfactant needed in the lungs of the fetus? And when during the pregnancy is it produced? |
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Definition
| Surfactant helps the aveloi to stay open. And it is produced during weeks21-23 |
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Term
| Why isn't wise for the fetus to be born at 21-23? |
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Definition
| Not enough capillary ability for gas exchange. |
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Term
| At what age are the fingernails and toenails present on the fetus? |
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Definition
| 29-32 weeks or gestional 31-34 |
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Term
| For the fetus when does bone marrow production of erythrocytes happen? |
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Definition
| 29-32 weeks or gestational 31-34 weeks |
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Term
| Fetus is vertex is due to what? |
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Definition
| Shape of uterus and fetal head heavier than the feet |
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Term
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Definition
| Waxy coat that helps protects the fetus. |
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Term
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Definition
| Fine downy hair on the fetus. |
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Term
| What is helps the fetus and neonate with thermoregulation? |
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Definition
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Term
| What is given to the mother if birth is imminent and the fetus lungs are not mature? |
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Definition
| The mother is given steroids to help develop the lungs of the fetus. |
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Term
| At what weeks of the pregnancy is there a good chance if birth was to happen that the chances are good for survival of the fetus? |
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Definition
| Weeks 29 to 32 or gestational 31-34 weeks |
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Term
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Definition
| It is the shiny side of the placenta or the fetal side. |
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Term
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Definition
| It is the maternal side of the placenta, the side attached to the uterin wall |
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Term
| What 4 things does that amniotic fluid promote? |
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Definition
1)cushioning
2)maintains temp
3)allows fetal movement
4)allows for symmetric development |
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Term
| What does the size of the fetus depend on? |
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Definition
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Term
| There are 3 vessels are in the umbilical cord, how many are arteries and how many veins? |
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Definition
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Term
| There are 3 shunts that close off once the fetus is born. Name all 3. |
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Definition
Ductus venosus-liver bypass
Ductus arteriosus-lung bypass
Foramen ovale-between left and right atriums |
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Term
| What are the normal vitals of a neonate? |
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Definition
Temp- 36.5-37 C (97.7-98 F)
HR- 120-140 beats/min
Respriations- 30-60 breaths/min
BP- oscillometric 65/41mmHg in arm and calf |
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Term
| What should the first prenatal visit consist of? |
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Definition
1)Complete health history and physcial exam of the mother
2)assessment of the embryo/fetus: like the fetal heart tones if >8-10 weeks, fundal height-measurement from symphysis pubis to the top if uterine fundus in cm
3) labs; Hb/Hc, blood type, Rh typing, rubella titer, Blood glucose, UA and culture, Hep B screen, STD screening,PAP smear, and offer drug screen
4)Psychosocial assessment |
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Term
| What are the frequency of prenatal visits? |
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Definition
1) Q 4 weeks first 28 weeks
2) Q 2 weeks from 29-36 weeks
3) Q week from 37 weeks to delivery |
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Term
| What does the Alpha Fetal protein test determine? |
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Definition
| Done at 16-18 weeks to screen for neural tube defects. |
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Term
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Definition
| is an obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix, this can cause uterine heamorrage. |
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Term
| How is an estimated date of birth done by Nagele's rule? And how using the McDonalds method? |
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Definition
First day of LMP, subtract 3 mons, add 7 days.
Use uterine size to indicate age by measuring,in cm, distance from symphysis pubis to top of uterine fundus |
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Term
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Definition
| Number of times a women has been pregnant ever. |
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Term
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Definition
| equals number of infants delivered after 20 weeks gestation, born dead or alive: multiple births count as one. |
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Term
| What does tpal stand for? |
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Definition
T=number of term infants born after 37 weeks
P= number if premature infants born between 20-37 weeks
A=number of pregnancies that ended in sponraneous or therapuetic abortion prior to 20 weeks
L= number of children currently alive |
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Term
| What is the purpose of the cervical plug? |
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Definition
| To protect against infection |
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Term
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Definition
| Softening of cervix from increasing blood flow |
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Term
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Definition
| Bluish color of cervix during pregnancy |
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Term
| What is the vaginal pH during pregnancy? |
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Definition
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Term
| What causes the increase size and number of glands in the breast during pregnancy? |
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Definition
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Term
| Cardiac Output decreases during pregnancy. True or False |
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Definition
| False It actually increases 10-15 bpm |
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Term
| Pulmonary and PVR increases or decreases during pregnancy? |
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Definition
| <40-50% causing a decrease in BP |
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Term
| Does blood volume increase or decrease during pregnancy? And by how much? |
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Definition
| Increases by 45% over prepregnancy levels |
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Term
| Why does airway resistence decrease during pregnancy? |
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Definition
| This is due to progesterone. This causes volume breaths to increase by 30-40 percent |
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Term
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Definition
| Separation of abdominal muscles. This can happen as the uterus enlarges |
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Term
| What musculoskeletal changes happens during pregnancy? |
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Definition
| Relaxation of pelvis joints, physiologic lordosis (sway back) and diastasis recti |
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Term
| What is the cause of nausea and vomiting during 1 trimester of pregnancy? |
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Definition
| Due to the increase in hCG. |
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Term
| What may result because the kidneys cannot filter all the sugar? |
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Definition
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Term
| What integumentary conditions can occur during pregnancy because of the increase levels of estrogen? |
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Definition
Cloasma: mask of pregnancy (darkening of face skin)
Linea nigra: line from umbilicus to pubic area
Striae gravidarum: stretch marks caused by increased adrenal steroid levels |
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